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Commercial Agency Application

The undersigned, Corporate Officer/Owner hereby makes application for hauling/non-hauling agency of Stevens Van Lines, Inc. and submits the following data in connection therewith:


Agency Application Attachments

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Applicant recognizes and understands that Stevens Van Lines, Inc. (“Stevens”) is obligated by law to use due diligence and reasonable care in selecting agents, and that Stevens will rely on the information included in and with this application in discharging such obligation with respect to any decision Stevens may make regarding appointment of applicant as its agent. Accordingly, applicant represents, promises, and warrants that: (1) The information included in and with this application is true, accurate, and complete to the best of applicant’s knowledge and belief; (2) Disclosure of the information included in and with this application does not violate any confidentiality or non-competition agreement(s) entered into by applicant or its principle(s)/shareholder(s), officers, or directors: (3) applicant’s undersigned representative has full authority to submit this application and to make the representations, promises and warranties set forth herein; and that (4) Certifies compliance with all federal and state regulations regarding the transportation of household goods, particularly those governing CDL’s and drug testing; (5) and Applicant will hold Stevens harmless from and against and indemnify Stevens for any and all claims made against Stevens as a result of the making of this application, the untruthfulness, inaccuracy of incompleteness of any of the information included in or with this application or the breach of applicant’s warranties made herein.

The undersigned hereby authorizes Stevens Van Lines, Inc. to investigate the veracity of statements contained in our Agency Application, as part of Stevens Van Lines, Inc.’s procedure for processing said applications. The undersigned further agrees to hold harmless all persons and companies from whom Stevens Van Lines, Inc. may seek, in good faith, information about the undersigned company and management thereof, which will assist Stevens Van Lines, Inc. with respect to the application. The undersigned hereby makes and gives Stevens Van Lines, Inc. and said persons and companies full release and discharge to all damages, claims and injuries of any kind resulting from said disclosures so long as the disclosures are made in good faith and reasonably related to the agency application, and the purpose of the use thereof is solely related to the determination of fitness as an agent for Stevens Van Lines, Inc. The undersigned further understands that it has the right to make a written request within a reasonable period of time for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation.


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